Nail abnormalities

Nail abnormalities are problems with the color, shape, texture, or thickness of the fingernails or toenails.

Considerations

Like the skin, the fingernails tell a lot about your health:

Beau lines are depressions across the fingernail. These lines can occur after illness, injury to the nail, eczema around the nail, during chemotherapy for cancer, or when you do not get enough nutrition.

Brittle nails are often a normal result of aging. They can also be due to certain diseases and conditions.

Koilonychia is an abnormal shape of the fingernail. The nail has raised ridges and is thin and curved inward. This disorder is associated with iron deficiency anemia.

Leukonychia is white streaks or spots on the nails often due to drugs or disease.

Pitting is the presence of small depressions on the nail surface. Sometimes the nail is also crumbling. The nail can become loose and sometimes falls off. Pitting is associated with psoriasis and alopecia areata.

Ridges are tiny, raised lines that develop across or up and down the nail.

Causes

Injury:

Crushing the base of the nail or the nail bed may cause a permanent deformity.

Chronic picking or rubbing of the skin behind the nail can cause median nail dystrophy, which gives a lengthwise split or ridged appearance of the thumbnails.

Long-term exposure to moisture or nail polish can cause nails to peel and become brittle.

Infection:

Fungus or yeast cause changes in the color, texture, and shape of the nails.

Bacterial infection may cause a change in nail color or painful areas of infection under the nail or in the surrounding skin. Severe infections may cause nail loss. Paronychia is an infection around the nailfold and cuticle.

Viral warts may cause a change in the shape of the nail or ingrown skin under the nail.

Thyroid diseases such as hyperthyroidism or hypothyroidism may cause brittle nails or splitting of the nail bed from the nail plate (onycholysis).

Severe illness or surgery may cause horizontal depressions in the nails Beau lines.

Psoriasis may cause pitting, splitting of the nail plate from the nail bed, and chronic (long-term) destruction of the nail plate (nail dystrophy).

Other conditions that can affect the appearance of the nails include systemic amyloidosis, malnutrition, vitamin deficiency, and lichen planus.

Skin cancers near the nail and fingertip can distort the nail. Subungal melanoma is a potentially deadly cancer that will normally appear as a dark streak down the length of the nail.

Hutchinson sign is a darkening of the cuticle associated with a pigmented streak and may be a sign of an aggressive melanoma.

Poisons:

Arsenic poisoning may cause white lines and horizontal ridges.

Silver intake can cause a blue nail.

Medicines:

Certain antibiotics can cause lifting of the nail from the nail bed.

Chemotherapy medicines can affect nail growth.

Normal aging affects the growth and development of the nails.

Home Care

To prevent nail problems:

DO NOT bite, pick, or tear at your nails (in severe cases, some people may need counseling or encouragement to stop these behaviors).

Keep hangnails clipped.

Wear shoes that do not squeeze the toes together, and always cut toe nails straight across along the top.

To prevent brittle nails, keep the nails short and do not use nail polish. Use an emollient (skin softening) cream after washing or bathing.

Bring your own manicure tools to nail salons and DO NOT allow the manicurist to work on your cuticles.

Using the vitamin biotin in high doses (5,000 micrograms daily) and clear nail polish that contains protein can help strengthen your nails. Ask your provider about medicines that help with abnormal-appearing nails. If you have a nail infection, you may be prescribed antifungal or antibacterial drugs.

When to Contact a Medical Professional

Call your health care provider if you have:

Blue nails

Clubbed nails

Distorted nails

Horizontal ridges

Pale nails

White lines

White color under the nails

Pits in your nails

Peeling nails

Painful nails

Ingrown nails

If you have splinter hemorrhages or Hutchinson sign, see the provider immediately.

What to Expect at Your Office Visit

The provider will look at your nails and ask about your symptoms. Questions may include whether you injured your nail, if your nails are constantly exposed to moisture, or whether you are always picking at your nails.

Tests that may be ordered include x-rays, blood tests, or examination of parts of the nail or the nail matrix in the laboratory.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 1997-2019, A.D.A.M., Inc. Duplication for commercial use must be authorized in writing by ADAM Health Solutions.